Prevention Programmes Can Reduce Social Inequalities In Health?

Background: Alcohol abuse in adolescence is a cause of social inequalities in health. This study aims to assess European alcohol abuse prevention interventions among adolescents effects on different social economic classes (SES). Methods: A systematic literature search identified all studies conducted in Europe and published after 1995, assessing effectiveness of interventions to prevent alcohol abuse among adolescents. Eight studies met the inclusion criteria, three were included: EU-DAP study evaluates Unplugged; Conrod study analyzes Preventure; Morgenstern study describes Aktion Glasklar. The authors of the studies were contacted to obtain a re-analysis according to SES. Results: In EU-Dap, disadvantaged SES children have greater benefits from the program than the others, particularly on drunkenness. Conrod study showed a similar short term reduction in alcohol use in both SES groups. In Morgenstern study, binge drinking students belonging to disadvantaged SES seems to get more benefits from the intervention compared to those of the wealthier classes. Conclusions: Two of the three studies included (EU-Dap and Morgenstern) showed a greater effectiveness among lower SES students, particularly to alcohol abuse. Prevention interventions appear to reduce social inequalities, although the weak is evidence, relying on a limited number of studies lacking power to show effects at the level of social strata. Moreover, the included studies don’t assess other prevention interventions, other than school-based; no evaluations have been done on “environmental” interventions, such as policies on alcohol accessibility or price. Assessing prevention equity effect is a priority, and it requires that evaluation studies consider SES as a standard variable to be collected and used in the testing.